A new study published in the Journal of Affective Disorders by University College London (UCL) suggests that women are 40% more likely to experience depression during their perimenopausal phase of life. This comes after a meta-analysis of 7 different studies with data from more than 9,000 women from all over the world. We take a look at why women are more likely to experience depression during perimenopause.
Menopause and depression: What’s the connection?
When the female body enters the perimenopausal stage, there are many fluctuations occurring to the likes of the hormones oestrogen and progesterone. Both of these hormones are known to have a significant impact on mood. This is because they directly impact the serotonin levels in the body which contribute heavily to feelings of happiness. An imbalance or fluctuations in these levels can cause emotional symptoms like anxiety, heightened sense of irritability, lower self confidence, and mood swings. For a deeper understanding of how these hormonal changes during menopause can specifically lead to anxiety, read more about the relationship between Menopause & Anxiety.
But it’s not just a lack of serotonin that is responsible for feelings of depression during perimenopause, sleep problems can be a huge contributing factor. There is plenty of literature to back the negative impact that insomnia has on mental health, and how it can contribute to depression. In fact, similar studies have shown that the variance of sleep disturbance during the perimenopausal phase is as high as 39-47%, which is alarming. Poor sleep also contributes to reduced cognitive functioning, poor physical and mental recovery, feelings of sadness, worthlessness, and guilt. It can not only increase the risk of depressive episodes, but can further perpetuate the cycle of poor sleep and poor mental health.
In addition to the above, there are a number of significant life changes that take place during a woman’s 40s, which is when perimenopause occurs. This includes career growth, children entering adulthood, and ageing parents which can collectively add extra pressure. This can present its own emotional challenges. Finding reasons to feel happy may feel difficult during this time in life. So what steps can be taken to reduce the chance of depression during perimenopause?
How to detect depression: Common symptoms
Early diagnosis and awareness is really important for any health condition, including depression. Depression during perimenopause is no different to experiencing it at any other time in life. And, although everyone’s experience of depression is slightly different, there are some common symptoms that psychologists look out for to help guide a diagnosis. These include:
- Not finding joy in things you once enjoyed
- Feeling low for a period of more than two weeks
- Feeling fatigued and tired most of the time
- Noticeable fluctuations in weight
- Changes in appetite and diet
- Low self-esteem and poor confidence
- Difficulty focussing and completing tasks
- Suicidal thoughts
If you, or someone you love is exhibiting any combination of these symptoms, it’s important to seek professional help.
But does depression ever really go away? And how is it treated?
Treatment options for depression during perimenopause
Thankfully, there are effective treatments available for depression which can provide remission from the above symptoms, whether you're going through menopause or not.
One of the most commonly known treatments for treating depression is antidepressants. Antidepressants work by balancing the neurotransmitters and hormones in the brain that are responsible for moods and emotions. Some people can find antidepressants helpful for managing a variety of depression symptoms. The most common type of antidepressants are SSRIs (Selective Serotonin Reuptake Inhibitors) – known to improve serotonin levels in the brain. Serotonin is what we call the ‘happy hormone’ and it plays an important role in improving mood. However, antidepressants can result in quite a few side effects and performance issues which have reduced their usage amongst many patients.
Another commonly utilised treatment option for depression is CBT (Cognitive Behavioural Therapy). CBT is a type of talking therapy which aims to reduce the impact of depression by helping to change the negative thought patterns which lead to feeling low. It does so by providing coping strategies, challenging negative thoughts and helps to develop a positive outlook towards life in general. This therapy requires regular sessions, the frequency of which can be decided on between you and your counsellor depending on your own individual needs.
Some people unfortunately don’t find antidepressants or CBT helpful when it comes to depression. In these instances, rTMS treatment for depression becomes a great option. Repetitive Transcranial Magnetic Stimulation (rTMS) is a non-invasive and drug-free approach which utilises gentle magnetic stimulation to increase electrical activity in the parts of the brain that are responsible for governing our mood. Multiple studies have found an increase in serotonin and dopamine levels of patients that have undergone this therapy. It is not only considered safe, but incredibly effective. This is only available on the NHS in a few locations in England, but there are private clinics offering rTMS treatment more widely.
Ultimately, the best approach to treating depression is what works best for you. Use any and all tools at your disposal with the help of a medical professional to provide guidance. Your doctor can suggest or devise a bespoke treatment plan to address your personal concerns.
Perimenopause can change your life
Perimenopause is a life-changing stage of life for many women all across the world. And while many people may see perimenopause and menopause as a simple bodily change, the impact it has on mental health and all areas of life is considerable. As mentioned, studies have shown how the risk of developing mental health disorders like depression increase quite significantly. Feelings of guilt, low self esteem and poor confidence are just some of the emotional struggles a woman may face during this time in life, which is why it is really important to surround yourself with loved ones who can provide the necessary support.
As with any medical issues, seeking treatment options early on can reduce disruption in your life and can help you regain quality of life again. Never hesitate to seek help, especially when it comes to the menopause!
